Understanding Adult Onset Still's Disease Diagnosis and Treatment

Making an adult onset Still’s disease diagnosis may involve a variety of tests and diagnostic techniques. There is no single test that can be performed to diagnose this disease. The patient’s doctor will likely discuss several different tests and tools because the symptoms of this disease may mimic the symptoms of several other diseases, such as lymphoma, mononucleosis or other rheumatic diseases.

Signs and Symptoms

The first step in diagnosing this disease is discussing the patient’s symptoms with them. The doctor will often perform a thorough physical exam. This disease may be suspected if the patient presents with a fever, a salmon-pink rash, or swollen joints. A sore throat and swollen lymph nodes are also common findings.

Diagnostic Imaging

Several different imaging tests may be done to look for the signs and symptoms of this disorder. The doctor may request and echocardiogram may be performed to look for any inflammation of the lining of the lungs or the heart.

Traditional x-rays may be performed to look for any changes in the wrists, foot, spine or finger joints. Other joints may also be x-rayed. The abdominal area and chest may also be x-rayed.

Computerized tomography or ultrasound may be performed to check and see if the patient has an enlarged spleen or liver. The ultrasound and/or computerized tomography will focus on the abdominal area.

Blood Testing

Blood tests play a major role in making an adult onset Still’s disease diagnosis. A complete blood count is almost always done to measure how many platelets, and red and white blood cells a patient has. When this disease is present, the patient’s red blood cells are often low, while their white blood cells are often high. Their platelets are also often high.

An erythrocyte sedimentation rate, also referred to as a sed rate, is often performed for inflammatory conditions like this disease. This test is used to measure how quickly a patient’s red blood cells settle when they are put into a test tube. When inflammation is present, the blood cells will generally fall faster, meaning, the sed rate increases.

Ferritin and C-reactive protein blood tests may also be performed. If a patient has this disease, their ferritin levels are often markedly elevated. Antinuclear antibodies and rheumatoid factor blood tests may be done in addition to the above blood tests. These two tests are typically negative for patients with this disease.

Liver function testing may be performed to check and see how well the patient’s liver is working. If a patient has this condition, the levels of certain liver enzymes may be elevated. Fibrinogen levels may also be tested because high levels could indicate this disease.

Treatment

The goal of adult onset Still’s disease treatment, it to control the symptoms as well as possible. Medications are the most commonly used treatment methods. Such medications include:

• Non-steroidal anti-inflammatory drugs
• Prednisone
• Tumor necrosis factor antagonists
• Methotrexate

Resources

MedlinePlus. (2009). Adult Still’s Disease. Retrieved on September 14, 2010 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/000450.htm

MayoClinic.com. (2010). Adult Still’s Disease. Retrieved on September 14, 2010 from MayoClinic.com: https://www.mayoclinic.com/health/adult-stills-disease/DS00792